Creating the right environment for end of life care in hospital.

Abstract

Older people often experience repeated admissions to hospital towards the end of life but they have less access to palliative care services than younger people and those with cancer. People aged over 75 have the highest hospital death rates. This integrative review found that cleanliness, homeliness, accessibility and atmosphere are important to create the optimal environment for older people at the end of life. Where possible, patients should be nursed in light, airy rooms with artwork displayed and views of nature or outside spaces. Privacy is important but there are mixed views about single rooms, with some preferring the social interaction of four-bed bays until the last stages of their illness. The patient's space should be personalised by including the individual's belongings and bedside objects to enable families to feel close to the dying person.